Gotta Get Off the RNY vs. Sleeve Seesaw: Heads or Tails, help me out!

[Dub 9,922]

The same decision tormented me. Which way.

Ultimately the surgeon emphasized a few things that clinched the deal for me two weeks before the surgery.

My only regret is not doing this sooner.

[Wolfgirl78 266]

I did a lot of research trying to decide between bypass and sleeve.

Some things influenced me. I never knew anyone else in person who had the sleeve. I knew several people who had bypass. One of those people died. The others gained all their weight back. Also I remember reading how you can stretch your bypass pouch out again but you cannot stretch your sleeve out. Yes it will grow some in size over the years but it will never go back to its original size. I'm four years out and can only eat 3-4 oz of dense Protein. I know you can regain on the sleeve if you eat the wrong foods but once you get back on the wagon your tool is still in tact. For example, I gained 30 of the 102 lbs back I lost. Started eating right again about two months ago and I've only 10lbs left to lose of 30 I gained.

Bypass seemed more intrusive to me. They actually reroute your plumbing. I didn't want to deal with malabsorption. I was self pay and when I went to my surgeon for our first meeting he asked me which surgery did I think was best for me and I told him the sleeve. And he agreed.

Those things are the things that sealed the deal for me on sleeve vs bypass.

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[summerset 5,261]

Also I remember reading how you can stretch your bypass pouch out again but you cannot stretch your sleeve out. Yes it will grow some in size over the years but it will never go back to its original size.

That's not entirely true. You can stretch both pouch and sleeve. When I was in for surgery another patient was in for revision of the sleeve because it stretched quite a lot over the years and he could easily eat what people would consider a "normal portion" and more.

And why should the bypass pouch be able to stretch out more than the sleeve? Doesn't make sense to me. Both pouch and sleeve have relatively small volumina left and both can stretch out again.

[catalina_uk 62]

My consulatant on the day of the op told me this: we are doing rny if your liver has shrunk enough for me to work around it, if not I will do you a sleeve coz is less complicated and if none of the above work I will place a gastric baloon and we will pick it up from there. On my op day I was 308 pounds ans I m 5.10. Let ur surgeon decide what's best.

[Inner Surfer Girl 12,015]

Also I remember reading how you can stretch your bypass pouch out again but you cannot stretch your sleeve out. Yes it will grow some in size over the years but it will never go back to its original size.

That's not entirely true. You can stretch both pouch and sleeve. When I was in for surgery another patient was in for revision of the sleeve because it stretched quite a lot over the years and he could easily eat what people would consider a "normal portion" and more.

And why should the bypass pouch be able to stretch out more than the sleeve? Doesn't make sense to me. Both pouch and sleeve have relatively small volumina left and both can stretch out again.

The pouch is created from the stretchy part of the stomach (the fundus). The sleeve is created by removing almost all of the fundus.

[summerset 5,261]

AFAIK about 80% of the fundus gets removed when doing gastric sleeve resection. It's not completely removed. Surgeons might use different techniques of course.

And there seems to be some contradicting information out there as well regarding stretching the sleeve:

http://www.obesitycoverage.com/weight-loss-surgeries/gastric-sleeve/gastric-sleeve-will-my-stomach-stretch

[Daisee68 2,493]

I don't really understand why people feel sleeve is less trauma when you are actually removing 80% of your stomach? What has your surgeon advised? I wanted sleeve initially until surgeon suggested RNY was a better option for me. I did the research and settled on RNY and am very happy I did. In the end, only you and your surgeon can decide.

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[KristenLe 5,979]

RNY is a longer surgery (under anesthesia for longer). The re-routing of the intestines is also more "complicated". They are also modifying the stomach in a similar fashion to the Sleeve - but they don't remove the old stomach. Both surgeries are "major" surgeries and both have risks. The biggest issue with me preferring sleeve over RNY is mal-absorption concerns.

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Edited June 10, 2016 by KristenLe

[Daisee68 2,493]

@@KristenLe - I understand your concerns and as I said to each his own, but my RNY only took an hour and I do not appear to have any malabsorption issues. To me, the removal of the majority of the stomach where you can never get it back is what scared me. RNY can actually be reversed (i.e. intestines rerouted). I understand why each person has their own concerns, but I just don't agree that sleeve causes "less trauma" to the body.

[Sajijoma 1,324]

I chose rny and I had a really easy and wonderful time with it. I had my 6 month labs done and all was well, no issues with mal absorption. I have great restriction, I was a complete sugar addict pre surgery and having the rny has curbed that because I absolutely do not want dumping syndrome and although I've only come close to dumping twice, that was enough to make me make sure I read my labels and followed my plan to the letter. For me, at my starting weight and knowing my triggers, this was the way to go for me. If rny scares you, even after talking to the surgeon, in the end it's your decision to make. You have to live with the results either way, so choose what makes you feel like you can be most successful and happy with your end results.

[leebick 448]

I was having the same dilemma. I want to make sure I do everything I can to be successful, because I'm only doing this surgery once. I was leaning towards RNY because my NUT told me that I would lose more weight than with the sleeve, but not necessarily that much more. I was leaning towards the sleeve because of worries about dumping syndrome and malabsorption (of food and medication- not that I take anything at this point, but still...) if I had RNY. I made "friends" with a woman on a different forum (totally unrelated to BWLS) who has been fantastically successful with her sleeve... and surprisingly, when I posted my indecision about which surgery to have on THIS forum, she answered me here! Small world, huh? Her experience gave me a more-positive outlook on losing with the sleeve. Additionally, I have 3 friends who've each had RNY. One sticks to her eating plan religiously and looks great, lost all her weight. The second did well for about a year but then loosened up her eating regimen and has regained close to 100 lbs. The 3rd woman has had nothing but problems since her surgery in October. She's had hernias and intestinal torsion, extensive hair loss, and looks skinny and ill. These are all things I'd been turning over (and over and over and over) in my mind, while trying to decide. At the first meeting with my surgeon, I told her I'd do RNY and spent the next week agonizing over it. I finally called and changed my choice to sleeve, and I've been satisfied with that decision ever since! I was originally scheduled for surgery on 5/26 but cancelled due to illness, so now I'm on the schedule for July 18 and I CAN'T WAIT!!

Anyhow... They are BOTH effective procedures, IF you stick to your meal/exercise plan. Do whatever you feel you'll be most comfortable with, knowing that if you follow your plans, you'll lose all the weight you need and want.

[ridgerunner 115]

Why does no one ever add the duodenal switch into the mix? Has anyone considered this as an option? If not, why not?

[leebick 448]

Why does no one ever add the duodenal switch into the mix? Has anyone considered this as an option? If not, why not?

My program does not offer the duodenal switch; just lap band, bypass, or sleeve.

[gina171 626]

Why does no one ever add the duodenal switch into the mix? Has anyone considered this as an option? If not, why not?

I am curious about this question as well, ridgerunner...

What's the tipping point between choosing RNY or DS?

[ridgerunner 115]

Did you get my PM gina171?